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Decortication of the lung

Laparoscopic lung resection is a minimally invasive surgical technique used to diagnose and treat chest problems. It is performed to remove a layer of fibrous tissue that covers the lung, chest wall, and diaphragm and causes restriction of lung elasticity.


In the endoscopic lung peeling procedure, three incisions are made in the chest, each of which is no more than 1 cm, compared to a single incision with a length ranging between 15-20 cm in traditional chest surgery.


These incisions provide an opening that allows a small, specialized camera to be inserted into the chest, allowing the entire chest cavity to be seen. The camera transmits the image from inside the chest to a video screen to guide the surgeon in performing the operation. He can also insert the surgical tools necessary to achieve the goal of the operation.

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Reasons for performing endoscopic lung peeling

There is usually a space between the lung and the chest wall that is less than 1 mm thick. This space is covered by a thin layer of fluid, but in some cases, such as pneumonia or after bouts of bleeding in the chest, this space may be filled with purulent fluid that may eventually harden and form a capsule of fibrous tissue around the lung. .


This type of infection is called pulmonary empyema and is classified into 3 degrees:



Grade 1: usually treated with antibiotics.

Second degree: This is the degree that is treated with endoscopic lung peeling or fibrinolytics.

Grade III: Often treated with open chest surgery.

Other health conditions that may require endoscopic lung resection include the following:



Lung tumors.

Chest thickening due to inflammatory conditions, such as rheumatoid arthritis.

Objectives of performing endoscopic lung peeling

The goals of performing a lung peeling procedure are:


Removing the layer of fibroblasts and allowing the lung to expand and regain its elasticity to be able to expand and deflate.

Eliminate the source of infection.

Preventing deformity resulting from pulmonary fibrosis.

Information about endoscopic lung peeling

Here are the most important information and details about the process:


before the operation

CT scanning before endoscopic lung peeling is one of the essential steps that determine the stage of pulmonary empyema and its cause. In addition to the CT scan, the following tests may be required:


Blood tests.

Lung function test (breathing test).


Then the surgeon will determine if the patient needs any other procedures or tests depending on his condition.


During the operation

In general, the patient may be exposed to these procedures during the endoscopic lung peeling procedure:


The patient will be anesthetized before surgery so that he sleeps deeply and painlessly during the procedure.

The surgeon will make several incisions in the chest wall.

The surgeon inserts a camera through one of these incisions and other small surgical tools as the procedure requires.

Once the procedure is completed, any instrument will be removed and the incisions will be surgically closed and covered with a bandage.

It should be noted that the process will take several hours.


After surgery

In general, the patient may experience the following after waking up from endoscopic lung resection:


The patient usually wakes up two or more hours after surgery.

The patient is connected to a number of devices to monitor his health condition and heartbeat.

The patient receives oxygen through tubes connected to the nose for a temporary period in some cases.

The patient usually feels pain, but it is not severe, and he can request painkillers from the medical staff.

There is a chest tube that may be connected to some patients to help collect lung fluid.

The patient is provided with a device that will help him breathe deeply to prevent infection.

The patient may be advised to wear special stockings to help prevent blood clots.

Patients remain in the hospital after the laparoscopic lung peeling procedure usually for 5-7 days, that is, until the need for tubes connecting the patient is eliminated. Analgesics are transferred from intravenous to oral when the patient leaves home, and the intake of liquid foods and then solid foods is gradually increased. 


Advantages of laparoscopic lung peeling compared to traditional surgery

Compared with traditional surgery, laparoscopic lung resurfacing has the following advantages:


Less pain after surgery.

Shorter hospital stay and faster recovery and return to work.

Reducing the risk of infection and bleeding.

Harms and risks of endoscopic lung resection

Things usually go well after an endoscopic lung resection procedure. Risks may include the following:


Pneumonia and lung infection.


Temporary or permanent nerve damage.

Organ damage near the operation site.

Anesthesia-related effects.

We have been performing laparoscopic lung peeling since 2007

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